Bacterial sexually transmitted infections II Flashcards

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1
Q

How is syphilis acquired?

A

Direct contact of mucous membranes

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2
Q

How many people are infected with syphilis every year?

A

50,000

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3
Q

What is the causative agent of syphilis?

A

Treponema pallidum

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4
Q

Is treponema pallidum gram negative or gram positive?

A

Gram negative

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5
Q

What is the shape of treponema pallidum?

A

Spirochete

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6
Q

Is treponema pallidum sensitive or insensitive to oxygen?

A

Extremely sensitive

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7
Q

What kind of microscopy is used to visualize treponema pallidum?

A

Darkfield (or direct fluorescence Ab test)

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8
Q

How is the syphilis lesion described?

A
  1. Painless ulcerated papule

2. Indurated (hardened)

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9
Q

When does secondary syphilis manifest?

A

2-8 weeks post-chancre

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10
Q

What are the symptoms of secondary syphilis?

A
  1. Flu-like - sore throat, headache, fever, myalgia, muscle ache, anorexia, lymphadenopathy
  2. Prominent skin lesions all over body - highly infectious
  3. Possible raised lesions condylomata lata - in skin folds
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11
Q

How are condylomata lata lesions described?

A

Soft, flat, moist, pink-tan, papules and nodules

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12
Q

Gummas (granulomatous lesions) are indicative of what stage of syphilis?

A

Tertiary

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13
Q

What are symptoms of congenital syphilis?

A

Rhinitis and maculopapular rash developing after birth

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14
Q

What is the diagnosis for syphilis?

A
  1. Darkfield / direct fluorescence microscopy
  2. Ab detection / serology (most common)
  3. Culture not available
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15
Q

What are nontreponemal tests for syphilis?

A

Measures antibody directed against cardiolipin

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16
Q

What are treponemal tests for syphilis?

A

Detect antibody specific to T. pallidum

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17
Q

If a patient with syphilis is treated and then administered a nontreponemal test, will it be positive or negative?

A

Negative (treponemal test will still be positive)

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18
Q

How is syphilis treated?

A
  1. Penicillin

2. Doxycycline or azithromycin if allergic to penicillin

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19
Q

All patients with urethritis should be tested for what other infections?

A

Gonorrhea and chlamydia

20
Q

What are some major symptoms of non-gonococcal urethritis in males?

A

Blood in urine or semen, dysuria, discharge from penis, pain with intercourse

21
Q

What are some major symptoms of non-gonococcal urethritis in females?

A

Abdominal pain, dysuria, fever and chills, pelvic pain, vaginal discharge

22
Q

What is the most common cause of non-gonococcal urethritis?

A

Chlamydia

23
Q

What are the minor players involved non-gonococcal urethritis?

A

Mycoplasma genitalium and ureaplasma urealyticum

24
Q

Do mycoplasma and ureaplasma have a cell wall?

A

No

25
Q

What is contained in the plasma membrane of mycoplasma and ureaplasma?

A

Sterols stolen from host cell

26
Q

Which bacteria have a fried egg appearance?

A

Mycoplasma

27
Q

M. genitalium is resistant to what drug?

A

Doxycycline

28
Q

Men with non-gonococcal urethritis (suspected ureaplasma) should be treated with what drug?

A

Doxycycline

29
Q

Recurrent non-gonococcal urethritis in men should be treated with what drug?

A

Azithromycin or quinolones

30
Q

What is the causative agent of chancroid?

A

Haemophilus ducreyi

31
Q

Is haemophilus gram negative or gram positive?

A

Gram negative

32
Q

What is the shape of haemophilus?

A

Pleomorphic coccobacillus

33
Q

What is the oxygen requirement for haemophilus?

A

Facultative anaerobe

34
Q

What is the catalase rating for haemophilus?

A

Catalase positive

35
Q

What does haemophilus require for growth?

A

X and V factors

36
Q

What is the presentation progression for H. ducreyi?

A
  1. 5-7 days post exposure a tender papule with an erythematous base develops on genitalia or perianal area
  2. Within 2 days lesion ulcerates and becomes PAINFUL
  3. Inguinal lymphadenopathy commonly present
37
Q

How is chancroid treated?

A

Macrolide: azithromycin, erythromycin

38
Q

What is the diagnosis for H. ducreyi?

A
  1. Slow growth on chocolate agar

2. Syphilis and HSV must be excluded

39
Q

What is the causative agent of donavanosis / granuloma inguinale?

A

Klebsiella granulomatis

40
Q

What is the gram staining for klebsiella granulomatis?

A

Gram negative

41
Q

What is the shape of klebsiella granulomatis?

A

Rod

42
Q

Is klebsiella granulomatis encapsulated?

A

Yes

43
Q

What is the appearance of klebsiella granulomatis lesions?

A

Wartlike, painless, bleed easily (NOT ulcerated)

44
Q

What is the diagnosis for klebsiella granulomatis?

A
  1. Rule out other causes

2. Presence of Donovan bodies in pathological specimens

45
Q

What is the treatment for klebsiella granulomatis?

A

Prolonged treatment with tetracycline, sulfamethoxazole, gentamycin, ciprofloxacin, or erythromycin